Biomedical waste management

1. BACKGROUND:
Proper handling and disposal of bio-medical waste is very essential. Unfortunately, laxity and lack of adequate knowledge and practice on bio-medical waste disposal leads to respectable health and environment apprehension. Biomedical waste, generated from a number of healthcare units, is imparted necessary treatment to reduce adverse effects that this waste may pose. Installation of individual treatment facilitates by small healthcare units requires comparatively high capital investment. In addition, it requires separate manpower and infrastructure development for proper operation and maintenance of treatment systems. A common bio medical waste treatment facility is used for treatment and disposal of bio medical waste.
2. INTRODUCTION:
Biomedical waste management has recently emerged as an issue of major concern not only to hospitals, nursing home authorities but also to the environment. The bio-medical wastes generated from health care units depend upon a number of factors such as waste management methods, type of health care units, occupancy of healthcare units, specialization of healthcare units, ratio of reusable items in use, availability of infrastructure and resources etc.(1)
The proper management of biomedical waste has become a worldwide humanitarian topic today. Although hazards of poor management of biomedical waste have aroused the concern world over, especially in the light of its far-reaching effects on human, health and the environment.(2)
Now it is a well established fact that there are many adverse and harmful effects to the environment including human beings which are caused by the “Hospital waste” generated during the patient care. Hospital waste is a potential health hazard to the health care workers, public and flora and fauna of the area. The problems of the waste disposal in the hospitals and other health-care institutions have become issues of increasing concern. (3)
2.1 Problems relating to biomedical waste:
A major issue related to current Bio-Medical waste management in many hospitals is that the implementation of Bio-Waste regulation is unsatisfactory as some hospitals are disposing of waste in a haphazard, improper and indiscriminate manner. Lack of segregation practices, results in mixing of hospital wastes with general waste making the whole waste stream hazardous. Inappropriate segregation ultimately results in an incorrect method of waste disposal.(4)
Inadequate Bio-Medical waste management thus will cause environmental pollution, unpleasant smell, growth and multiplication of vectors like insects, rodents and worms and may lead to the transmission of diseases likes typhoid, cholera, hepatitis and AIDS through injuries from syringes and needles contaminated with human.(5)
2.2 Need of biomedical waste management in hospitals:
The reasons due to which there is great need of management of hospitals waste such as:
1.      Injuries from sharps leading to infection to all categories of hospital personnel and waste handler.
2.      Risk of infection outside hospital for waste handlers and scavengers and at time general public living in the vicinity of hospitals.
3.      Risk associated with hazardous chemicals, drugs to persons handling wastes at all levels.
4.      “Disposable” being repacked and sold by unscrupulous elements without even being washed.
5.      Drugs which have been disposed of, being repacked and sold off to unsuspecting buyers.
6.      Risk of air, water and soil pollution directly due to waste, or due to defective incineration emissions and ash.(3)
2.3 Biomedical Waste Management Process:
 The hospital waste like body parts, organs, tissues, blood and body fluids along with soiled linen, cotton, bandage and plaster casts from infected and contaminated areas are very essential to be properly collected, segregated, stored, transported, treated and disposed of in safe manner to prevent  hospital acquired infection.
1.      Waste collection
2.      Segregation
3.      Transportation and storage
4.      Treatment & Disposal
5.      Transport to final disposal site
6.      Final disposal
2.4 Biomedical Waste Treatment and Disposal:
Health care waste is a heterogeneous mixture, which is very difficult to manage as such. But the problem can be simplified and its dimension reduced considerably if a proper management system is planned. There are some techniques for the treatment and disposal of biomedical waste:
1. Incineration
2. Autoclaving
3. Microwave irradiation
3. CONCLUSION:
Medical wastes should be classified according to their source, typology and risk factors associated with their handling, storage and ultimate disposal. The segregation of waste at source is the key step and reduction, reuse and recycling should be considered in proper perspectives. We need to consider innovative and radical measures to clean up the distressing picture of lack of civic concern on the part of hospitals and slackness in government implementation of bare minimum of rules, as waste generation particularly biomedical waste imposes increasing direct and indirect costs on society. The challenge before us, therefore, is to scientifically manage growing quantities of biomedical waste that go beyond past practices. If we want to protect our environment and health of community we must sensitize ourselves to this important issue not only in the interest of health managers but also in the interest of community.
 4. RECOMENDATION:
1.      Every hospital should have special boxes to use as dustbin for bio-medical waste.
2.      Bio-medical waste should not be mixed with other waste of Municipal Corporation.
3.      Private hospitals should also be allowed to use incinerator, which is installed, in govt. hospital. For this purpose a specific fee can be charged from private hospitals.
4.      Special vehicle i.e. bio-medical waste vehicle should be started to collect waste from private hospitals and private medical clinics and carry it up to the main incinerator.
5.      Bio-medical waste Management Board can be established in each District.
5. REFERENCES:
1.      Mandal S. K. and Dutta J. , Integrated Bio-Medical Waste Management Plan for Patna City, Institute of Town Planners, India Journal 6-2: 01-25 (2009).
2.      Singh V. P., Biswas G., and Sharma, J. J., Biomedical  Waste  Management  –  An Emerging Concern in Indian Hospitals Indian, Journal of  Forensic Medicine & Toxicology, Vol. 1, No. 1. (2007-12).
3.      Hem Chandra, Hospital Waste an Environmental Hazard and Its Management, (1999).
4.      CEET: Biomedical Waste Management-Burgeoning issue (2008).
5.      Govt. of India, Ministry of Environment and Forests Gazette notification No 460 dated July 27,New Delhi: 1998: 10-20.

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 BY: SAGAR BARAL
CiST, Sangam chowk, baneshwor,
Kathmandu, Nepal

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